fitworld rehab gust

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TM The demand for physical therapy is exploding at such a rate the industry must turn to technology to meet this growing need and expand the tradi8on reach of therapy from the clinic to the home. A rapidly aging popula8on, the increasing incidence of diseases driven by sedentary lifestyles, and stunning medical advances in joint replacement are all contribu8ng factors to this dilemma. Pa8ent engagement required for high efficacy both in clinic and at home is a cri8cal challenge in solu8on design. The Problem We Solve Highly Confiden8al – Respondesign Inc. – Copyright 2013 Armed with low cost sensor technology through the use of Microso;’s Kinect for Windows mo>on sensor, Respondesign has created FitWorld to address these challenges for both the physical therapist and the rehab pa>ent. Kinect for Windows is now a rapidly maturing commercial hardware & middleware plaForm through which we deeply integrate our solu>on for clinic & home therapy delivery.

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Page 1: Fitworld rehab gust

TM  

The  demand  for  physical  therapy  is  exploding  at  such  a  rate  the  industry  must  turn  to  technology  to  meet  this  growing  need  and  expand  the  tradi8on  reach  of  therapy  from  the  clinic  to  the  home.    A  rapidly  aging  popula8on,  the  increasing  incidence  of  diseases  driven  by  sedentary  lifestyles,  and  stunning  medical  advances  in  joint  replacement  are  all  contribu8ng  factors  to  this  dilemma.    Pa8ent  engagement  required  for  high  efficacy  both  in  clinic  and  at  home  is  a  cri8cal  challenge  in  solu8on  design.  

The  Problem  We  Solve  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013    

Armed  with  low  cost  sensor  technology  through  the  use  of  Microso;’s  Kinect  for  Windows  mo>on  sensor,  Respondesign  has  created  FitWorld  to  address  these  challenges  for  both  the  physical  therapist  and  the  rehab  pa>ent.    Kinect  for  Windows  is  now  a  rapidly  maturing  commercial  hardware  &  middleware  plaForm  through  which  we  deeply  integrate  our  solu>on  for  clinic  &  home  therapy  delivery.  

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Respondesign’s  rehab  solu8on  provides  physical  therapists  a  tool  to  deliver  an  engaging,  personalized  rehab  program  that  includes  pa8ent  monitoring  &  clinician  repor8ng.    Equipped  with  MicrosoP’s  Kinect  for  Windows  mo8on  sensor,  rehab  facili8es  are  able  to  deliver  a  consistent  care  offering  for  the  pa8ent  both  in  the  care  facility  and  at  home.  

Our  Solu>on  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

Page 3: Fitworld rehab gust

Fitworld  increases  therapist  produc8vity  through  automa8on  tools  that  provide  data  and  results.  Therapists  can  quickly  assign  a  series  of  therapeu8c  exercises.    Through  deep  integra8on  with  the  Kinect  for  Windows  mo8on  sensor  Fitworld  logs  evidence  of  the  prescribed  treatment  documen8ng  date,  8me,  movement,  repe88ons,  dura8on  and  other  details,  stored  in  a  pa8ent’s  secure  record  on  the  Fitworld  cloud  service.  For  pa8ents,  the  visual  and  audio  feedback  along  with  scoring  for  accurate  performance  is  empowering  and  encouraging  of  a  deeper  par8cipa8on  in  the  rehab  experience.    

TM  

-­‐  Automated  Care  Delivery  -­‐  Improved  Pa>ent  Experience  -­‐  Evidence  Based  Tracking  &  Repor>ng  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

BePer  Rehab  

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Fitworld  -­‐  The  Rehab  Cycle  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

Assess  Assign  Therapist  

Pa8ent   Therapist  &  Pa8ent  

Therapist  

Monitor    Perform  

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TM  

Fitworld  TM  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

Fitworld  was  designed  for  easy  access  for  both  the  healthcare  professional  and  pa8ent  home  use  as  a  cloud-­‐based  app  with  mul8ple  levels  of  access  authority.    In  a  clinical  seWng  accompanied  by  a  physical  therapist  Fitworld  for  rehab  requires  a  Windows  computer  with  MicrosoP’s  Kinect  for  Windows  mo8on  sensor.    At  home  the  client  can  access  Fitworld  for  Rehab  without  Kinect  on  a  SmartTV,  Mac,  Android  or  Windows  PC  using  any  web  browser.  

PT  Administered  In  Facility  

Pa>ent  Performed  At  Home  Without  

Kinect    

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Rehab  Demand  Drivers  

These  challenges  will  increase  as  30  million  new  people  enter  the  healthcare  system  in  2013  via  Obamacare.  

+27%  Demand    Growth    

by  2016  

Bureau  of  Labor  Sta8s8cs,  APTA,  Forbes  2009  

18%  PT  Jobs  Are  Open  

Geriatric    Physical  Therapist  

Shortage  39.6  Million    

to  

 72.1  Million    by  2030  

19%  of  US  Popula8on  by  2015  

Elderly  Popula8on  Growth  

262%    Increase  in  Hip  &  Knee  Replacements    

2006  -­‐  2015  

Orthopedic  Rehab  On  The  Rise  

Na8onwide  Inpa8ent  Sample  (NIS)  

Health  and  Human  Services  Administra8on  of  Aging  

TM  

The  Burden  of  Musculoskeletal  Diseases  in  the  United  States,  2004  Report  

$510  Billion  Cost  Of  Treatment  

$399  Billion  In  Lost  Wages    

Musculoskeletal  Condi8ons  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

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Rehab  Market  

Outpa8ent   Inpa8ent   Home  Care  

Hospital  IRF  Skilled  Nursing  Facility  

Contract  Rehab  Manager  Top  6:  6,927  loca8ons  

Hospitals:  4,900  Assisted  Living:  20K  Nursing  Homes:  16K    

CCRC:  2,000  

16K  Clinics  

Highly  Fragmented  

$20B  in  Revenue  

23K  loca8ons  

Least  expensive,  fastest  growth  

$57B  in  Revenues  

TM  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

Page 8: Fitworld rehab gust

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Rehab  Market  -­‐  Outpa>ent  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

The  outpa8ent  rehabilita8on  therapy  industry  in  the  US  consists  of  about  30,000  establishments  with  combined  annual  revenue  of  approximately  $20  billion.  The  industry  is  highly  fragmented,  with  the  top  50  companies  accoun8ng  for  less  than  25  percent  of  total  revenue.  The  outpa8ent  rehabilita8on  industry  accounts  for  nearly  $5  billion  of  Medicare  spending.  This  figure  has  been  rising  steadily,  and  has  more  than  doubled  since  2000  when  annual  rehabilita8on  expenditures  were  $2.1  billion.*  

*  Brocair  Partners  –  Overview  of  the  Outpa6ent  Rehabilita6on  Market  2011  

•   Highly  fragmented  U.S.  outpa8ent  rehab  market,  over  16,000  clinics.  

•   No  outpa8ent  company  with  more  than  6%  market  share.  

•   Three  largest  outpa8ent  rehab  companies:  − Select  Medical    952  clinics  − Physiotherapy  Assoc.  657  clinics  − USPh    419  clinics  

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TM  

Rehab  Market  –  Inpa>ent  Customer  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

Customer:  Genesis  Rehab  Services  Objec8ve:  Falls  Preven8on  Solu8on:  Balance  In  Ac8on  Otago  Exercise  Program.  Fitworld  based  version  of  the  Otago  exercise  rou8nes  that  are  now  in  use  worldwide*.    A  muscle  strengthening  and  balance-­‐retraining  exercises  of  increasing  difficulty,  combined  with  a  walking  program.    Evidence-­‐based:  Fall  rate  was  reduced  by  35  percent  among  program  par8cipants*.    Genesis  is  currently  beginning  internal  trials.  

Genesis’  “Balance  in  Ac.on”  (BIA)  system  will  be  implemented  in  over  1,100  cap.ve  and  outsourced  rehab  facili.es  na.onwide.    

Source:  CDC,  Campbell,  et  al.  and  Robertson,  et  al  

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TM  

Rehab  Market  -­‐  Inpa>ent  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

Long  Term  Acute  Care  Hospitals  &  Inpa>ent  Rehab  

Facili>es  

Contract  Rehab  Manager  

Skilled  Nursing  &  Rehab  Centers  

Currently  there  are  47.6  million  Medicare  beneficiaries  with  an  es8mated  9,100    individuals  added  to  the  program  each  day  

35%  of  Medicare  Beneficiaries  Are  Discharged  From  Acute  Hospitals  to  Post-­‐

Acute  Care  

Pa8ents  first  site  of  discharge  

aPer  acute  care:    

41%  Skilled  Nursing  

Pa8ent  use  of  site  during  90-­‐day  episode:    52%  Skilled  Nursing  

RTI, 2009: Examining Post Acute Care Relationships in an Integrated Hospital System

Kindred Healthcare, November 2012

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TM  

Rehab  Market  –  Home  Care  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

Home  Health  care  industry  includes  about  23,000  establishments  (single  loca8on  companies  and  branches  of  mul8-­‐loca8on  companies)  with  combined  annual  revenue  of  $57  billion.  

Demand  Drivers  Include:  •   Aging  popula8on:  10K  US  ci8zens  become  eligible  for  Medicare  each  day  •   High  cost  of  skilled  nursing  facili8es  •   Rise  of  accountable  care  organiza8ons  (ACO)  that  coordinate  care  to  increase  efficiency  and  reduce  costs  •   Innova8on  and  leveraging  the  use  of  technology  is  a  repeated  industry  theme  

Pa8ents  first  site  of  discharge  

aPer  acute  care:    

37%    Home  Health  Care  

Pa8ent  use  of  site  during  90-­‐day  episode:    61%    Home  Health  Care  

Kindred:  RTI,  2009:  Examining  Post  Acute  Care  Rela8onships  in  an  Integrated  Hospital  System  

Gen6va  Corp.  Investors  Presenta6on  ,  December    2012  

CMS  HCIS  data  files  for  2006.  Hospital  data  includes    PPS  and  non-­‐PPS.  Home  health  day  calculated  based  on  60-­‐day  episode  

Lower  Cost  Per  Day  vs.  Hospital  &  SNF  

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TM  

Fitworld    -­‐  Business  Model  

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013  

Learning  from  the  Genesis  deal  and  understanding  their  model  for  care  delivery  we  have  developed  a  license  based  business  model  for  Fitworld.    This  model  is  based  on  a  site/seat  based  license  fee  along  with  professional  services  fees  for  content  and  feature  customiza8on.  Home  use  of  Fitworld  with  repor8ng  to  their  rehab  clinician  and  popula8on  repor8ng  to  Genesis  Rehab  administra8on  could  be  billed  to  user  directly  or  to  the  user’s  “payor”  based  on  monthly  usage.    The  Genesis  deal  was  ground  breaking  and  financial  terms  were  not  op8mal.    They  are  a  strategic  partner  and  we  agreed  to  exclusivity  for  one  year  for  “elder  care  falls  preven8on”  rehab  category.      

Highly  Leveragable  Architecture  The  Fitworld  plarorm  is  purpose  built  to  allow  for  the  integra8on  of  several  categories  of  proscribed  rehab  fitness  as  well  as  general  fitness  &  injury  preven8on.    With  its’  cloud  app  architecture  and  real-­‐8me  content  delivery  model,  Fitworld  is  highly  customizable  for  both  features  and  content  allowing  for  rapid  deployment  and  single  point  of  delivery  for  new  feature  deployment.  

Compe>>ve  Advantage  Respondesign’s  advantage  is  our  speed  to  market,  flexible  architecture  and  support  for  rehab  clinician  program  design  and  publishing.    We  have  deep  integra8on  with  the  Kinect  mo8on  sensing  technology  through  a  deep  technical  and  market  development  partnership  with  MicrosoP’s  Kinect  for  Windows  group.    Our  management  team  has  significant  soPware  start  up  thru  public  company  experience  in  developing  and  deploying  consumer  facing  enterprise  plarorm  soPware.  

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Management  Team  Ted  Spooner  -­‐  CEO:  Co-­‐founder  of  RDI  with  company  development  experience  ranging  from  start-­‐up  to  IPO.    SoPware  development  experience  in  both  enterprise  and  consumer  facing  applica8ons.  As  founder  and  CEO,  Ted  took  Corillian,  Inc.  public  in  2000  (Nasdaq:  CORI).    Corillian  was  sold  to  CheckFree  (Nasdaq:  CKFR)  in  2007  for  $245m.      

Jason  Leighton  -­‐  CTO:  RDI  co-­‐founder  and  game  industry  veteran  of  over  15  years,  Jason  has  been  at  the  forefront  of  emerging  technologies  right  from  the  beginning  of  his  career.  The  first  game  series  he  worked  on,  "Descent",  went  on  to  become  one  of  the  bestselling  and  most  iconic  games  of  a  genera8on.  Jason  has  worked  for  THQ,  Atari,  and  Interplay,  in  both  management  and  senior  developer  roles.  He  has  been  Respondesign's  Chief  Technology  Officer  since  2003  where  he  directed  the  efforts  that  led  to  "Yourself  Fitness"  and  the  mul8-­‐million  selling  UbisoP  8tle  "My  Fitness  Coach".  

John  Grispon  –  EVP  Sales,  Marke>ng  &  Business  Development:  Co-­‐founder  with  a  demonstrated  capacity  to  lead  organiza8ons  ranging  from  a  first-­‐year  start-­‐up  to  a  global  soPware  giant.    Previously  he  founded  Brain  Thaw,  a  marke8ng  consultancy  for  start-­‐ups,  ran  the  business  development  division  of  Corillian,  Inc.,  the  online  banking  pioneer  now  part  of  Fiserv,  and  spent  nearly  12  years  at  MicrosoP  Corpora8on  with  his  last  post  as  Worldwide  Banking  Industry  Manager.    

Highly  Confiden8al  –  Respondesign  Inc.  –  Copyright  2013